Healthcare Provider Details

I. General information

NPI: 1710819057
Provider Name (Legal Business Name): NICOLAS ARTHUR JADOT LMFT
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/01/2026
Last Update Date: 06/01/2026
Certification Date: 06/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

919 THE ALAMEDA
BERKELEY CA
94707-2301
US

IV. Provider business mailing address

1241 GRIZZLY PEAK BLVD
BERKELEY CA
94708-2127
US

V. Phone/Fax

Practice location:
  • Phone: 510-213-4464
  • Fax:
Mailing address:
  • Phone: 510-213-4464
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number162630
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: